Replace a full arch with four implants — and teeth that stay in place.
If most or all of the teeth in one arch are already missing or can no longer be predictably saved, the All-on-X® concept uses four strategically positioned implants to support a fixed full-arch restoration.
Four implants. One fixed arch. A completely different experience from removable dentures.
Six things to understand before replacing a full arch.
All-on-X isn’t simply a denture with implants underneath. The number and position of the implants, the fixed restoration and the way the arch is planned all make it a different treatment concept.
Four implants support the arch
Rather than placing one implant for every missing tooth, four strategically positioned implants can support a complete fixed arch.
The back implants are angled
The All-on-X concept uses two anterior implants and two posterior implants that may be tilted to make strategic use of available anatomy and bone.
Your teeth stay fixed in place
The restoration is secured to the implants rather than removed by you each night like a conventional or snap-in denture.
Grafting may sometimes be avoided
The implant positioning is specifically designed to use available bone efficiently, which can allow treatment without bone grafting in appropriately selected cases.
Temporary teeth may be placed right away
When the implants achieve the stability and clinical criteria needed for immediate loading, a fixed provisional arch can be delivered on the day of surgery.
Fixed doesn’t mean maintenance-free
The restoration stays attached, but the implants and tissues underneath still need careful daily cleaning and professional maintenance.
Four implants doesn’t mean four teeth — they can support an entire fixed arch.
2 front implants + 2 strategically angled back implants = one foundation designed to support a complete fixed arch.
The strategy isn’t simply using fewer implants. It’s where those four implants go.
The original All-on-4® treatment concept uses two straighter implants toward the front of the jaw and two posterior implants positioned at an angle, which can help make use of available bone while avoiding important anatomical structures.
Those four implants create the foundation for a single fixed full-arch restoration. That means the replacement teeth work together as one prosthesis supported by the implants rather than each missing tooth receiving its own individual implant.
For patients who meet the clinical requirements and whose implants achieve adequate initial stability, a fixed provisional restoration may also be connected on the day the implants are placed. The definitive restoration comes later, after healing and the restorative plan are ready for that next stage.
It’s designed for a full arch — but patients can arrive there from very different starting points.
The decision depends on your remaining teeth, bone, gums, health and restorative goals — not simply how many teeth you’re missing.
Already Missing All Your Teeth
All-on-4 can create a fixed full-arch alternative for someone currently living without natural teeth or wearing a complete removable denture.
- For fully edentulous patients who want to explore teeth that remain fixed to implants rather than a denture they remove themselves.
- For selected patients with a terminal or failing dentition who may need remaining teeth removed as part of a planned full-arch rehabilitation.
Most Teeth Are Failing
Sometimes an arch still has teeth present, but extensive decay, fractures or periodontal problems mean they cannot predictably support the smile long term.
Traditional Dentures Aren’t Enough
Some patients can wear removable dentures successfully but want the confidence and function of a restoration that does not come out at home.
- For denture wearers whose priority is moving from a removable prosthesis to a fixed full-arch implant restoration.
Plan the full arch. Place the four implants. Build your final smile.
- Plan teeth, bone & implant positions
We evaluate your remaining teeth, gums, jawbone, bite and imaging to determine whether a four-implant full-arch approach fits your anatomy and restorative goals.
- Place the implants & provisional teeth
The four implants are strategically positioned. When immediate-loading criteria are met and adequate stability is achieved, a fixed provisional arch may be attached the same day.
- Heal, refine & complete the final arch
As the implants heal, we monitor your tissues, bite and provisional restoration. Your definitive fixed teeth are then designed and delivered according to the final restorative plan.
200 reasons to choose us.
We don't ask you to trust us. We let our patients do the talking.
I hadn’t been to the dentist in longer than I wanted to admit, so I was expecting a lecture. Instead, the whole visit felt easy. My cleaning was gentle, everything was explained clearly, and I left knowing exactly what to keep an eye on and when to come back.
Melissa R.
Teeth Cleaning & Exam
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I had a small chip on my front tooth that bothered me in every photo. I expected a much bigger treatment, but bonding was enough. The shade matches beautifully and the tooth still looks completely natural.
Laura M.
Cosmetic Dental Bonding
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I drink coffee every day and felt like my teeth had gradually become much darker than they used to be. I wanted them brighter, but I definitely didn’t want that artificial super-white look. They helped me choose a shade that still looked like me, and the difference was exactly what I wanted. My smile looks fresher without looking “done.”
Emily S.
Professional Teeth Whitening
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I avoided the dentist for years because of a terrible experience when I was younger. By the time I finally booked, I was embarrassed about both my teeth and how anxious I was. Nobody made me feel judged. They talked through the sedation options with me beforehand, explained exactly what to expect and made the appointment feel completely manageable. It was the first time I left a dental office thinking, “I can actually do this again.”
Lauren D.
Sedation Dentistry
Kensington, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I used to think preventive dentistry just meant getting my teeth cleaned and coming back six months later. They actually took the time to explain why I kept getting cavities in the same areas and helped me change a few things at home. We also added extra protection to a couple of teeth that needed it. My visits feel much more proactive now instead of waiting for the next problem.
Nicole B.
Preventive Dentistry
Kensington, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I had been dealing with jaw soreness and painful clicking for months and wasn’t even sure whether I should see a dentist about it. The appointment was very thorough. They asked when the pain happened, checked how my jaw was moving and explained the difference between the joint and the surrounding muscles. I appreciated that the plan felt conservative and specific to what I was actually experiencing.
Sarah L.
TMJ Evaluation & Treatment
Chevy Chase, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I had already been diagnosed with sleep apnea but struggled with my CPAP enough that I wasn’t using it consistently. I talked with my sleep doctor about alternatives and then came to Bethesda Dental Group for an oral appliance. The fitting process was easy, the adjustments were explained clearly, and traveling is much simpler now. My wife is also very happy that the snoring has improved.
James R.
Sleep Apnea Oral Appliance Therapy
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I had a badly broken molar and kept putting the appointment off because I was nervous about having it removed. They showed me why the tooth couldn’t really be saved, talked me through everything before starting, and the actual extraction was much more manageable than I had built it up to be. I also appreciated that we talked about what to do with the space afterward instead of just stopping there.
Rachel P.
Tooth Extraction
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I went in with a toothache that had kept me up the night before and was honestly dreading hearing “root canal.” The team explained exactly what they were seeing and what would happen next. Once I was numb, the appointment was much easier than I expected, and the relief afterward made me wish I had come in sooner.
Michael T.
Root Canal Treatment
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I chipped an old filling and was convinced it was going to turn into a much bigger procedure. Dr. Shawn showed me exactly what was happening, explained my options clearly, and repaired the tooth without making the visit stressful. My bite feels completely normal again, and the new filling blends in so well I can barely see it.
Daniel M
Composite Filling Replacement
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
A full-arch solution is a big decision. Financing can make the investment easier to manage.
We accept most PPO insurance plans and can help you understand any benefits that may apply to your treatment. Cherry, Sunbit, Proceed and Care Credit financing is also available for eligible implant care with no hard credit check · approval in seconds · and plans from 3 to 24 months.
If the whole arch is failing, you don’t have have to replace one tooth at a time.
Whether you’re already wearing dentures or facing the loss of most of your teeth, we’ll evaluate your bone, remaining teeth and goals to see whether All-on-4 could give you a fixed way forward.
